Chronic diarrhoeas in infancy and childhood. II. Enzyme content of duodenal juice.

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Abstract
In 42 normal infants and children and in 70 infants and children with chronic diarrheas, the amylase, lipase, and trypsin content of the duodenal juice was studied during fasting or following oral stimulation by a test meal. Both methods revealed such marked variations in the quantity of all 3 enzymes that it is impossible to define a normal range. Neither of the 2 methods proved superior. The amylase activity in the fasting duodenal juice from infants under 6 months of age was low, and lipase activity was lower in infants and children under 2 years of age than from children over 2 years. A consistently low enzyme activity was found only in patients with mucoviscoidosis, while infants and children with a normal sweat test, normal fat excretion, and normal D-xylose tolerance test had enzyme values no lower than a control group. Infants and children having normal sweat tests but abnormally low D-xylose tolerance tests failed to show evidence of any reduced pancreatic exocrine function. A group of infants and children with normal sweat tests and normal D-xylose tolerance tests, but an increased excretion of fat, showed moderately low values for some of the enzymes, suggesting that in such cases pancreatic exocrine insufficiency may be of significance. Study of the duodenal juice is particularly indicated for this category of child with chronic diarrhea.